Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
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Paradoxical embolism is an uncommon but clinically important phenomenon. Elements of diagnosis include the presence of: (1) a venous thrombus, (2) an arterial embolus, (3) a communication between the right and left heart, and (4) a thrombus traversing such a communication. ⋯ A transesophageal echocardiogram with contrast should be considered in cases where paradoxical embolism is a possibility. We present a case in which a "thrombus-in-transit" was imaged across the interatrial septum in a patient with a patent foramen ovale, deep venous thrombosis, and an embolic cerebrovascular stroke.
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A miniaturized 5.5 to 10 MHz, phased-array, single longitudinal plane transducer mounted on a 3.3-mm diameter catheter (miniaturized transesophageal echocardiography [TEE]) may overcome mechanical limitations of standard pediatric transesophageal probes. We evaluated whether the miniaturized TEE probe could define clinically relevant anatomy in 17 infants who weighed less than 6 kg. ⋯ Miniaturized TEE provided diagnostic intraoperative TEE in the majority of infants studied and may allow broader and safer application of TEE to neonates and small infants.
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J Am Soc Echocardiogr · Aug 2002
Comparative StudyDoppler tissue velocity, strain, and strain rate imaging with transesophageal echocardiography in the operating room: a feasibility study.
Transesophageal echocardiography (TEE) is increasingly used to monitor regional myocardial function during cardiac operation. Doppler myocardial imaging (DMI) indices can potentially provide new information on regional radial and longitudinal myocardial motion and local deformation. This study examined the feasibility of TEE acquisition of regional radial and longitudinal velocity, displacement (D), strain, and strain rate data during cardiac operation and evaluated the effects of sternotomy and pericardial opening on these indices. ⋯ DMI with TEE is feasible during cardiac operation. During pericardial opening, longitudinal D decreases in the septum, but not in the inferior wall. DMI requires further evaluation in the assessment of ventricular function and the detection of ischemia in the operating room.
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J Am Soc Echocardiogr · Aug 2002
Case ReportsEntrapment of mitral chordal apparatus causing early postoperative dysfunction of a St. Jude mitral prosthesis.
Preservation of subvalvular apparatus is increasingly performed during mitral valve replacement. We describe a case of early postoperative St. Jude mitral valve dysfunction as a result of chordal entrapment.